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A new report from the International Journal of Clinical Practice revealed that the Mayo Clinic’s 40-year-old “gold standard thyroid screening test” is flawed, and compromising the adequacy of conventional thyroid treatment (1).

As a result, many thyroid problems and thyroid-related symptoms go undiagnosed or untreated.

Many patients go on thyroid medication, but often, their symptoms don’t change! Others are told their thyroid is normal even though they are experiencing symptoms. This may lead to the prescribing of many more unnecessary drugs to address the original symptoms, simply because the flawed test led doctors away from the true cause of the symptoms, and left them looking for answers in other therapies.

Read on and find out:
• If you are suffering from a chronic thyroid condition and don’t know it.
• Why you may not be feeling good even if you are on thyroid medication, and what to do next.

Please take my Home Thyroid Self-Assessment Screening and make sure that what is ailing you is not related to a misdiagnosed or undiagnosed thyroid condition.

A Flawed Test.

For the last 40 years, medical doctors have relied on one test to diagnose thyroid troubles: The TSH test. The TSH test measures levels of TSH, a hormone produced by the pituitary gland when it recognizes that thyroid hormones are low, signaling the thyroid to make more thyroid hormones. When TSH levels are high, it’s a sign that the thyroid is hypo-, or under, active. Conversely, low or nonexistent levels of TSH point to a hyper, or over-active, thyroid.

Normal TSH Test Results Don’t Mean Your Thyroid Is Healthy!
In 2010, according to data dating back 40 years, Dr DS O’Reilly reported that there have been no published studies linking a TSH test result in the normal range to the relief of symptoms in a patient and a normally functioning thyroid(2). In other words, the TSH blood test can be normal but the patient may still have thyroid symptoms, leaving them with an undiagnosed and consequently untreated thyroid problem.

In that same study, 50% of the individuals who took T4 thyroid medication and reported symptomatic relief then had a TSH test that was out of the normal range. In these cases, doctors routinely lower the medication to bring the TSH test back up to normal, at which point many patients re-develop their original hypothyroid symptoms. But with the TSH now back in “normal” range, doctors are reluctant to re- adjust the dose even though the symptoms are re-surfacing.

The important pattern to notice here is:

The results of the TSH test are often not consistent with how the patient is feeling.

Sally: A Case Study

Sally, a patient of mine, was experiencing fatigue, brain fog, constipation and weight gain. With the help of a TSH test, her doctor diagnosed her with hypothyroidism and high cholesterol. She was prescribed thyroid medication and was told that the combination of the thyroid medication along with some dietary changes and exercise would help both the thyroid and the cholesterol.

In a follow-up appointment three months later, the TSH test showed a “normal thyroid.” But Sally’s cholesterol was still high, and she was still feeling exhausted and constipated and struggling with brain fog, and the weight had not budged. She was still experiencing all these symptoms, even though her thyroid now tested normal.

Her doctor prescribed a Statin drug to lower her cholesterol and Sally was told to retest her thyroid in three months.

Sally was now on two medications and still not feeling any better.

Here’s what went wrong: At Sally’s follow-up appointment, the TSH test told the doctor that her thyroid was normal even though her symptoms had not cleared. The doctor was treating the blood test, not the patient. In addition her high cholesterol, often the result of an under-active thyroid, was being treated by another drug rather than naturally coming down as the result of a healing thyroid.

Relying on a blood test can often distract doctors from the original question of why symptoms are presenting themselves in the first place.

Home Thyroid Self Assessment Screening

Before blood tests were available, the thyroid was evaluated by basal body temperature and the signs and symptoms presented by the patient. Today these traditional tests have been replaced by modern blood tests. It has now become clear that these blood tests alone will not offer an accurate thyroid diagnosis. Use the Home Thyroid Self Assessment Screening below, along with the thyroid blood tests from your doctor, to get the most precise evaluation of your thyroid.

Step 1: Morning Axillary Temperature Test

Each morning before getting out of bed and before much movement, take your temperature under your arm (in your arm pit). Do this for 5 days and get the average temperature. It should be greater than 97 degrees F. If it is lower and you are experiencing some of the hypothyroid symptoms listed below, you may have sluggish thyroid function. Some digital thermometers are designed to take axillary (underarm) temperature. The old fashioned mercury thermometers also work well (shake down the thermometer before bed the night before, so you move as little as possible before taking your temperature in the morning).

Step 2: Take the following yes-or-no questionnaire.

• Are you fatigued or lethargic compared to how you’ve typically felt in the past?
• Do you have aversion to or intolerance of cold?
• Does your mind feel foggy?
• Has your memory declined recently?
• Do you have an increased need for sleep?
• Are you experiencing slow and steady weight gain?
• Are you constipated?
• Do you have dry, coarse skin?
• Have the outside thirds of your eyebrows become thinner?
• Are you experiencing hair thinning or hair loss?
• Do you have high cholesterol?
• Is it difficult to get out of bed in the morning?
• Is it difficult to enjoy life because it takes too much energy?
• Do the muscles in your arms and legs cramp for no reason?
• Do your joints hurt?
• Do you find it difficult to concentrate?
• Do you just feel “off” and can’t really explain it?
• Are you fingers and toes always cold?
• Are you feeling depressed?
• Do you find yourself cancelling evening or weekend plans regularily because you just don’t have the energy?

All of the above are signs and symptoms of a low-functioning thyroid. If you answered “yes” to 5 or more of these questions and your first morning axillary temperature test is below 97 degrees, you may have a thyroid condition.

If This is You.

Have your doctor run a Reverse T3 test. The most common marker for an undiagnosed low thyroid is a test called Reverse T3 (rT3). RT3 hormone is the reverse or opposite of the thyroid hormone T3. When rT3 levels are high it will slow the thyroid and is commonly found in hypothyroism. Most doctors don’t run this test so you must ask for it.

Thyroid Dysfunction and Toxic Metals

Interestingly, Dr. Jonathan Wright reported that elevated rT3 levels may be linked to elevated levels of toxic metals. When the toxic metals are removed by oral chelation, the rT3 returns to normal. The thyroid is an extremly chemically sensitive gland and detoxing the thyroid must be considered in the treatment of most thyroid conditions.

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Dr. John Douillard

Dr. John Douillard, DC, CAP is a globally recognized leader in the fields of natural health, Ayurveda and sports medicine. Over the past 30 years, he’s helped over 100,000 patients repair their digestive system and eat wheat and dairy again. He is the creator of LifeSpa.com, a leading Ayurvedic health and wellness resource on the web with over 4.5 million views on YouTube. Receive his valuable health reports in your inbox - sign up for free! LifeSpa.com is evolving the way Ayurveda is understood around the world, with over 700 articles and videos proving ancient wisdom backed by modern science. Dr. John is the former Director of Player Development and nutrition advisor for the New Jersey Nets NBA team, author of six books, a repeat guest on the Dr. Oz show, and has been featured in Woman’s World Magazine, Yoga Journal, the Huffington Post and dozens of other publications.
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How would this affect someone who has had a TT for papillary cancer? I've heard several of my fellow thyroid cancer survivors talking about having TSH levels in the "normal" range after taking synthetic hormones, but still not feeling good. I'm currently going hypo on purpose in prep for RAI next week, so very interested in this subject.

I totally agree with this article! And how happy I am that I am not totally crazy.

I have been taking thyroid hormone replacement since I was 15. So for the last 25 years I have argued over and over with my Endocrinologist that I am not getting relief of symptoma and I do not care what his blood tests are telling him.

My hair falls out, my fingers and toes are cold even when it is 95 degrees outside. I suffer from depression and have never in my life had energy to do much of anything.

When I first started treatment my Doctor told me I would be able to lose weight once my levels were normal, and let me tell you That has NOT happened. Losing weight is so difficult. Diet and exercise do not help, and I get worn out trying to do the work outs.

I am so happy that you published this. My Endocrine Doctor will be getting an earful when I see him next.

This is only half the information. Which TSH test are you referring to as inadequate and inaccurate? The standard if care is to test TSH 3 and 4. This is an accurate measure of thyroid function. Presenting only half the information in your article is misleading and inaccurate.

I was diagnosed with Hashimoto's hypothyroid a couple of years ago and luckily my Synthroid is working well. But as you write, I am lucky to have a doctor who evaluates based on how I'm FEELING, and not solely on the blood tests. But as to your comment about it being underdiagnosed, I think I probably had these symptoms for 2 years without having any idea that there was something wrong with my thyroid. Lots of people as they get older just think it's normal that they are feeling fatigued and think nothing of it. That was definitely my situation! But now I know there is no reason for us to feel so exhausted and lethargic all the time and with proper diagnosis we can be well-treated and get back to our normal selves. Thanks for sharing!!- Jeannie

If you are reading this letter then chances are that you or someone you love is suffering with the above symptoms. I understand what a frustrating and debilitating impact it can have on every area of your life.

In my work as a Chiropractor and Kinesiologist over the past 10 years I have seen literally thousands of people who are struggling daily with these problems….in fact I would say there is a huge epidemic of undiagnosed thyroid problems (especially hypothyroid, or under-functioning thyroid glands) in our modern Western society. This hidden epidemic is robbing people of their energy, their motivation, their self esteem and their quality of life.

Unfortunately, it is very common when thyroid lab tests are normal but a patient still experiences hypothyroid symptoms.

Normal lab test results are relative because normal range varies from lab to lab and is also different in different countries. In US new normal TSH is from 0.3 to 3.0 and was officially suggested in 2002, however many doctors and labs still continue to use outdated numbers.

It is really important to look into the details, know your numbers and make sure that your thyroid labs are optimized for the optimal health.

Can the thyroid test be wrongly interprated in the hyperthroidism direction? My wife had none of the symptions of hypothyroidism but L-thyroxine was perscribed because TSH reading was elevated. Three months later her TSH is normal but she has symptons of hyperthroidism. Shouldn't she stop the L-thyroxine?

This doctor just told my story!!!!
My doctor is untrained in thyroid issues, which is why I was undiagnosed for many years (my TSH was always within range- even at the low end! and even though my FT4 was a little under, it didn't "matter" apparently because my TSH was ok). They wanted to treat my high cholesterol and depression with separate drugs, and told me to exercise more. The special endocrinologist they sent me to was the worst- the one who was supposed to understand the thyroid just brushed me off and told me I was fine. I begged and begged my GP for thyroid meds (my dad and half of his 10 siblings were diagnosed hypo), and finally the dr relented. Guess what- my depression went away, my cholesteral improved, my fits of anger, inability to cry, severe intolerance to cold, early staged of carpal tunnel, hair loss, fatigue, and brain fog left me. Even my voice and my skin changed. That sounds so crazy, but it is true, that was all somehow related to my body not receiving the thyroid hormones it needed. I was pretty hypo, thanks to the stupid TSH test showing I was normal.
So I am exactly who this article is describing. Interesting thaT rt3 was mentioned. My doctor won't test me for that- apparently it isn't a worthwhile test, but I suspect it might be one that I should have had before starting my thyroid supplement. If it truly is a metal toxicity problem, then haven't I just fixed the wrong issue? How do I go about removing metal toxins so my thyroid can heal while being on thyroid supplements, can I do that or must I go off of the thyroid meds first?

Good article, but the some of the symptoms are very close to Adrenal Fatigue Syndrome. If you think you have a thyroid problem… Make your dr test.. TSH, T3, T4, rT3, TBG, and anti-TPO. If you think maybe AFS then add… estrogen, testosterone, ACTH, DHEA, sodium, HCI acid, and cortisol (this is more accurate with a saliva test 4x a day). Make sure you get a copy! Do your own research also! If you think an autoimmune, then get an ANA test done also!

Thyroid issues are very common in the US but please don't try to self-diagnose. Many of these symptoms can occur with both under and over active thyroid. If you are guessing you have Hashimoto's (autoimmune hypothyroidism, very common) and up your thyroid hormone you could end up doing serious harm if what you really have is Graves Disease (autoimmune hypERthyroidism). Some people swing between both. Get yourself properly tested not just for TSH but also t3 and t4 as well as testing for antibodies that would indicate an autoimmune condition which does have serious implications. Get regular blood tests. Make your dietary changes based on what's really going on. Don't just guess according to symptoms.

I was just diagnosed with Hashimoto's disease last year at Mayo Clinic after having symptoms for 20 years. They never looked for Hashimoto's because my TSH was always in normal levels. My health went downhill about 6 years ago and my doctors could not figure out what was wrong with me. Although I am feeling better I am still symptomatic. I write about my struggles at http://toughtriciabraveb.wordpress.com. Maybe some of you can relate.

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Hello! I have had the diagnosis of M.E./CFS for two years now, but recently read about the sign of 'hair loss on outer third of eyebrows' being a symptom of possible thyroid issue, so reasearching further. I also fit many of the other symptoms.

However, I initially had many many blood tests and discussions taken and all came back normal (apparently). I am keen to ask for specific blood tests now to check, but am starting to feel better due to nutritional changes.

Am feeling a bit lost as to what to think now? Could it be a thyroid issue on top of M.E? Or perhaps that's what's been causing the fatigue and brain fog!! ??????

I really don't know what to do. I have been pushing away my friends and art projects because they require energy, also have been looking so sleepy during work commitments and studying for SATS. The point is I've been getting complaints that I am looking restless cause I felt like my mind is sort of foggy and my back felt like it wants to hunched back. I am really tired and I get dehydrated quickly. I even gained weight and find it hard to lose weight. I've just visited women's clinic, let's hope I get result to recover. I'm so frustrated and cranky cause tired. TIRED THAT THE BLOOD AND THYROID TEST ARE ALL NORMAL AND LEFT ME UNMEDICATED. EVEN VITAMINS DOESN'T WORK. I EVEN LOST THE MOOD TO EXERCISE When I'm with family, I'm quiet. My SATS tutor is so concerned about my health can't even last an hour to just sit down and concentrate and the fact that I must fidget in order to keep me awake. :/ WHAT DOCTOR SHOULD I SEE? I've shown the normal results to endocronologist , something like that and they rejected to wanting to see me.